1. The undersigned, being the registered owner of the Vehicle described above, or (in the case of a company-owned vehicle) the person so authorized, hereby give permission to Affordable Interlock Systems Pty Ltd, together with its employees, agents and contractors (collectively the “Service Agent”) to install an approved alcohol interlock device for use by participant/s in the listed vehicle herein.
2. The information collected on this permission will be used to assist in the management and recording of the installation and will not be used or disclosed to a third party without consent, unless authorised or required to be law.
3. I acknowledge that the alcohol interlock device will be installed in the Vehicle under a Service Agreement between the Service Agent and the Participant identified herein, pursuant to which the Service Agent has the right to recover possession and remove the alcohol interlock device from the Vehicle in the event of default by the Participant, and I hereby undertake not to interfere with any such action should it become necessary.
4. I also acknowledge that should the participant default in their payment for any reason, as the registered owner of the vehicle shall be responsible for making good all such outstanding payments including but not limited to the cost of the removal of the device. I further acknowledge that such removal will take place at an authorised AIS service center and it shall be at the owners cost to deliver the vehicle to the service center.
By signing the below, I confirm that I am the registered owner of the Vehicle with full authority to bind and acknowledge and accept full responsibility as set out above.